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Venous Drainage Patterns in Carotid Cavernous Fistulas

机译:颈动脉海绵窦瘘的静脉引流方式

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摘要

Purpose. The carotid-cavernous fistula (CCF) is an abnormal arteriovenous communication and its drainage pathways may affect the clinic presentation and change treatment approach. We evaluated drainage patterns of CCFs by digital subtraction angiography (DSA) and categorized drainage pathways according to their types and etiology. Materials and Methods. Venous drainage patterns of 13 CCFs from 10 subjects were studied and categorized as anterior, posterior, superior, inferior, and contralateral on DSA. Drainage patterns were correlated to types and etiology of CCFs. Diagnosis of CCFs was first made by noninvasive imaging techniques. Results. On DSA, traumatic CCFs were usually high flow, direct type while spontaneous CCFs were usually slow flow, indirect type. Bilaterality and mixed types were observed among the indirect spontaneous CCFs. In all CCFs, anterior and inferior drainages were the most common. Contrary to the literature, posterior and superior drainages were noted only in high flow and long standing direct fistulas. Contralateral drainage was not observed in all, supporting plausible compartmentalization of cavernous sinuses. Conclusion. Types, etiology, and duration of the CCFs may affect their drainage patterns. DSA is valuable for categorization of CCFs and verification of drainage patterns. Drainage pathways may affect the clinic presentation and also change treatment approach.
机译:目的。颈动脉海绵窦瘘(CCF)是动静脉沟通异常,其引流途径可能会影响临床表现并改变治疗方法。我们通过数字减影血管造影(DSA)评估了CCF的引流方式,并根据其类型和病因对引流途径进行了分类。材料和方法。研究了来自10位受试者的13个CCF的静脉引流模式,并在DSA上分为前,后,上,下和对侧。排水方式与CCF的类型和病因相关。 CCF的诊断首先是通过无创成像技术进行的。结果。在DSA上,创伤性CCF通常是高流量,直接型,而自发CCF通常是慢流量,间接型。间接自发CCFs中观察到双边性和混合类型。在所有CCF中,最常见的是前引流和下引流。与文献相反,仅在高流量和长期站立的直接瘘管中才注意到后部和上部引流。完全没有观察到对侧引流,支持了海绵窦的合理分隔。结论。 CCF的类型,病因和病程可能会影响其引流方式。 DSA对于CCF的分类和排水模式的验证非常有价值。引流途径可能会影响临床表现并改变治疗方法。

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